Individual
LUDOVIC MARIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10530 WARWICK AVE STE C2, FAIRFAX, VA 22030-3132
(704) 994-4754
Mailing address
10530 WARWICK AVE STE C2, FAIRFAX, VA 22030-3132
(704) 994-4754
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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